中老年大骨节病患者下颈椎椎体高度及前后径的X线测量及其临床意义

doi:10.13418/j.issn.1001-165x.2023.4.05

中国临床解剖学杂志 ›› 2023, Vol. 41 ›› Issue (4): 395-400.doi: 10.13418/j.issn.1001-165x.2023.4.05

中老年大骨节病患者下颈椎椎体高度及前后径的X线测量及其临床意义

吴学元¹，易智¹，凌鸣¹*，刘时璋¹，孙正明¹，谢利民²

1.陕西省人民医院骨科，西安 710068； 2.城固县第二人民医院骨科，陕西汉中 723200

收稿日期:2022-05-31 出版日期:2023-07-25 发布日期:2023-08-02
通讯作者: 凌鸣，主任医师，E-mail：m.ling0114@163.com
作者简介:吴学元（1981-），男，陕西西安人，副主任医师，博士，主要从事大骨节病脊柱方面的研究，E-mail：wuxueyuan81@163.com
基金资助:
陕西省自然科学基础研究计划项目（2019JM-517）；陕西省人民医院科技发展孵化基金（2019YXQ-10）；陕西省重点研发计划-社会发展领域（2018ZDXM-SF-054）

X-ray measurement and clinical significance of height and anterior-posterior diameter of lower cervical vertebral body in elderly patients with Kashin-Beck disease

Wu Xueyuan¹, Yi Zhi¹, Ling Ming¹*, Liu Shizhang¹, Sun Zhengming¹, Xie Limin²

1. Department of Orthopedics, Shaanxi Provincial People's Hospital , Xi’an 710068, Shaanxi Province, China; 2. Department of Orthopedics, Chenggu Country the Second Hospital, Hanzhong 723200, Shaanxi Province, China

Received:2022-05-31 Online:2023-07-25 Published:2023-08-02

摘要/Abstract

摘要： 目的测量大骨节病（Kashin-Beck disease，KBD）患者下颈椎椎体的X线参数，明确KBD对下颈椎椎体发育的影响。方法分别对62例KBD患者（KBD组）及67例正常人（对照组）行颈椎侧位X线片检查，观察颈椎椎体的影像学特征，测量两组C3~7椎体前缘、中份及后缘高及前后径，并进行统计学分析。结果 KBD患者下颈椎椎体上、下面凹凸不平，终板凹陷、硬化。颈C3~7椎体前、后缘高大于中份高，椎体前、后缘高无统计学差异（P>0.05）；KBD组男性C4~6和女性C4~7的椎体中份高小于前、后缘，差异有统计学意义（P<0.05）。对照组男性C4~7及女性C3~7椎体中间高均高于KBD组，差异有统计学意义（P<0.05）。KBD患者男女组间前后径有统计学差异（P<0.05）；对照组男女前后径较KBD组大，差异无统计学意义（P>0.05）。结论 KBD可引起终板软骨凹陷、不平及硬化，导致颈椎中间高度降低，但对颈椎前后径无明显影响。

关键词: 大骨节病； , , 椎体高度； , , 终板软骨； , , 颈椎； , , 影像学形态

Abstract: Objective To measure the X-ray related parameters of lower cervical vertebral body in elderly patients with Kashin-beck disease (KBD), so as to clarify the influence of KBD on the development of lower cervical vertebral body. Methods Sixty-two patients with KBD (KBD group) and sixty-seven healthy people (control group) were treated with lateral cervical radiographs to observe the imaging manifestations of the lower cervical vertebral body. The anterior, middle and posterior heights of the vertebral body and anterior-posterior diameters from C3 to C7 in neutral position were measured and statistical analysis was performed. Results The results of this study showed that the superior and inferior margins of the vertebral endplate were uneven, depressed and sclerosis in some KBD patients. The heights of anterior and posterior margins of vertebral body were higher than that of the middle margin, and there was no significant difference between the height of anterior and posterior margins (P>0.05). In the KBD group, the median heights of C4-6 in males and C4-7 in females were smaller than that of anterior and posterior margin, and the difference was statistically significant (P<0.05). The median heights of C4-7 in males and C3-7 in females in the control group were higher than that in the KBD group, with statistically significant difference(P<0.05). There were significant differences in anterior-posterior diameters between male and female groups in the KBD patients (P<0.05). The anterior -posterior diameters of males and females in the control group were larger than those in the KBD group, but there was no statistical difference (P>0.05). Conclusions KBD can cause the depression, uneven and sclerosis of endplate cartilage, lead to the reduction of the middle height of cervical vertebral body, but do not affect the development of anterior -posterior diameters of the vertebral body.

Key words: Kashin-Beck disease； , Vertebral heights； , Endplate cartilage； , Cervical vertebrae, Radiographic morphology

中图分类号:

R681.5

吴学元, 易智, 凌鸣, 刘时璋, 孙正明, 谢利民. 中老年大骨节病患者下颈椎椎体高度及前后径的X线测量及其临床意义[J]. 中国临床解剖学杂志, 2023, 41(4): 395-400.

Wu Xueyuan, Yi Zhi, Ling Ming, Liu Shizhang, Sun Zhengming, Xie Limin. X-ray measurement and clinical significance of height and anterior-posterior diameter of lower cervical vertebral body in elderly patients with Kashin-Beck disease[J]. Chinese Journal of Clinical Anatomy, 2023, 41(4): 395-400.

参考文献 16

[1]	Guo X, Ma WJ, Zhang F, et al. Recent advances in the research of an endemic osteochondropathy in China: Kashin-Beck disease[J]. Osteoarthritis Cartilage, 2014, 22(11): 1774-1783. DOI: 10.1016/j.joca.2014.07.023.
[2]	丁界先, 刘璐, 李伦, 等. 基于关键词的大骨节病中文文献研究主题剖析[J]. 中华医学图书情报杂志, 2014, 23(9): 20-24. DOI: 10.3969 / j.issn.1671-3982.2014.09.005.
[3]	Wang KW, Yu J, Liu H, et al. Endemic Kashin-Beck disease: a food-sourced osteoarthropathy[J]. Semin Arthritis Rheum, 2020, 50(2): 366-372. DOI: 10.1016/j.semarthrit.2019.07.014.
[4]	Lian W, Liu H, Song QQ, et al. Prevalence of hand osteoarthritis and knee osteoarthritis in Kashin-Beck disease endemic areas and non Kashin-Beck disease endemic areas: a status survey[J]. PLoS One, 2018, 13(1): e190505. DOI: 10.1371/journal.pone.0190505.
[5]	国家卫生健康委员会. 2021中国卫生健康统计年鉴[M]. 北京: 中国协和医科大学出版社, 2021: 272.
[6]	Fu GT, Chen XQ, Qi M, et al. Status and potential diagnostic roles of essential trace elements in Kashin- Beck disease patients[J]. J Trace Elem Med Biol, 2022, 69: 126880. DOI: 10.1016/j.jtemb.2021.126880.
[7]	Li H, Liu Q, Li QW, et al. Prevalence of pediatric Kashin-Beck disease in Tibet[J]. Clin Rheumatol, 2021, 40(9): 3717-3722. DOI: 10.1007/s10067-021-05669-9.
[8]	Wu XY, Ling M, Chang YH, et al. Accidental or linked: separated odontoid process fused to the enlarged anterior arch of the atlas associated with atlantoaxial subluxation in a Kashin-Beck disease patient[J]. Eur Spine J, 2017, 26(Suppl 1): 85-89. DOI: 10.1007/s00586-016-4783-y.
[9]	Li Y, Kang PD, Zhou ZK, et al. Magnetic resonance imaging at 7.0 T for evaluation of early lesions of epiphyseal plate and epiphyseal end in a rat model of Kashin-Beck disease[J]. BMC Musculoskelet Disord, 2020, 21(1): 540. DOI: 10.1186/s12891-020-03559-w.
[10]	Wu XY, Ma W, Du H, et al. A review of current treatment of lumbar posterior ring apophysis fracture with lumbar disc herniation[J]. Eur Spine J, 2013, 22(3): 475-488. DOI: 10.1007/s00586-012-2580-9.
[11]	郭雄. WS/T 79-2011《大骨节病治疗效果判定》标准解读[J]. 中国卫生标准管理, 2017, 8(24): 1-3. DOI: 10.3969/j.issn.1674-9316. 2017. 24.001.
[12]	刘锦波, 唐天驷, 杨惠林, 等. 中下颈椎体应用解剖测量及临床意义[J]. 中国临床解剖学杂志, 2001(1): 23-24. DOI: 10.13418/j.issn.1001-165x.2001.01.008.
[13]	Costa L, de Reuver S, Kan L, et al. Ossification and fusion of the vertebral ring apophysis as an important part of spinal maturation[J]. J Clin Med, 2021, 10(15): 3217. DOI: 10.3390/jcm10153217.
[14]	Day G, Frawley K, Phillips G, et al. The vertebral body growth plate in scoliosis: a primary disturbance of growth[J]? Scoliosis, 2008, 3:3. DOI: 10.1186/1748-7161-3-3.
[15]	中共中央地方病防治领导小组办公室. 永寿大骨节病科学考察文集[M]. 北京: 人民卫生出版社, 1984: 434.
[16]	Xu HM, Hu F, Wang XY, et al. Relationship between apoptosis of endplate microvasculature and degeneration of the intervertebral disk[J]. World Neurosurg,2019,125: e392-e397. DOI:10.1016/j.wneu. 2019. 01.085.

中老年大骨节病患者下颈椎椎体高度及前后径的X线测量及其临床意义

X-ray measurement and clinical significance of height and anterior-posterior diameter of lower cervical vertebral body in elderly patients with Kashin-Beck disease

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 16

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	江剑宏, 段仁鹏, 李晓锋. 国人胆道三维重建解剖变异应用研究[J]. 中国临床解剖学杂志, 2024, 42(1): 1-4.
[2]	郭红志, 王瑜, 张加琪, 梁海彬, 马梓玮, 冯伟, 吴忧, 司子燚. 血管铸型结合CT三维模型评估先兆子痫胎盘血管结构[J]. 中国临床解剖学杂志, 2024, 42(1): 5-10.
[3]	李佳伟, 张静, 李灿然, 兰文杰, 籍庆余, 郭志勇, 张云凤, 刘启, 陈清威, 李筱贺. 蒙古族人群股骨近端解剖参数X线测量[J]. 中国临床解剖学杂志, 2024, 42(1): 11-16.
[4]	李琨, 张燕, 郭冉, 郝咪咪, 吴轩宇, 徐艺芳, 王超群, 马文童, 张灵淇, 杨宏宇, 李志军, 张少杰, 王星. 儿童及青少年枕颈角与后枕颈角数字化测量及其临床意义[J]. 中国临床解剖学杂志, 2024, 42(1): 17-20.
[5]	李文, 杨思艺, 黄蕾, 卿霁雯, 蒋松涛, 张磊. 基于MRI探讨Lisfranc韧带的形态学特点及临床意义[J]. 中国临床解剖学杂志, 2024, 42(1): 21-25.
[6]	李凡凡, 徐阳, 王晓旭. 紫草素调节Nrf2/HO-1信号通路对实验性大鼠肉芽肿性小叶性乳腺炎的治疗作用研究[J]. 中国临床解剖学杂志, 2024, 42(1): 26-32.
[7]	王兴航, 丁佳媛, 李放, 包翠芬, 阎丽菁. 人参皂苷Rg1通过抑制NLRP3炎症小体途径减轻氧糖剥夺/复供后小胶质细胞炎症反应[J]. 中国临床解剖学杂志, 2024, 42(1): 33-41.
[8]	程莹莹, 武建军, 蔡海燕, 焦旭文, 马江波, 丁银秀. 体外炎性诱导星形胶质细胞激活及功能分析[J]. 中国临床解剖学杂志, 2024, 42(1): 42-46.
[9]	祁志, 杨力, 贾秋叶, 陈浩伦, 段兆达, 吴春云. 依达拉奉经MAPKs通路对脂多糖激活的小胶质细胞Sirt3表达调控[J]. 中国临床解剖学杂志, 2024, 42(1): 47-53.
[10]	张晶晶, 王洪新. 黄芩苷通过PDGF/P38 MAPK信号通路对肺动脉高压大鼠的保护作用[J]. 中国临床解剖学杂志, 2024, 42(1): 54-58.
[11]	乐钦, 陈荣丽, 熊婧熙, 王婷怡, 蔡志恒, 易秋实, 曾心怡. 白芨多糖对大鼠跨区皮瓣choke区的影响[J]. 中国临床解剖学杂志, 2024, 42(1): 59-64.
[12]	李笑予, 张磊, 付磊, 李东波, 汪国友. 三步接骨法治疗Sanders Ⅱ型跟骨骨折的有限元研究[J]. 中国临床解剖学杂志, 2024, 42(1): 65-70.
[13]	吴研飞, 马剑雄, 卢斌, 王颖, 柏豪豪, 靳洪震, 马信龙. CT后处理技术重建CT值与终板抗压强度的相关性研究[J]. 中国临床解剖学杂志, 2024, 42(1): 71-76.
[14]	庄万强, 唐毅, 骆勇刚, 张辉. 关节镜联合胫骨高位截骨术对髌骨位置及髌股关节功能影响的早中期回顾性研究[J]. 中国临床解剖学杂志, 2024, 42(1): 77-82.
[15]	罗鹰, 窦伟誉, 吴小杭, 陈璟昆, 彭昌贵, 潘剑英 . 微创海马钢板内固定治疗跟骨骨折并发症的影响因素[J]. 中国临床解剖学杂志, 2024, 42(1): 83-88.